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Are there gender-specific differences in pregnancy outcome and placental abnormalities of pregnancies complicated with small for gestational age?

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Introduction

Adaptations to pathological intrauterine environment might differ in relation to fetal gender. We aimed to study sex-specific differences in placental pathology of pregnancies complicated by small for gestational age (SGA).

Methods

The medical records and placental histology reports of all neonates with a birth-weight ≤ 10th percentile, born between 24 and 42 weeks of gestation, during 2010–2018, were reviewed. Composite neonatal outcome was defined as one or more of early following complications: neonatal sepsis, blood transfusion, phototherapy, respiratory morbidity, cerebral morbidity, necrotizing enterocolitis, or death. Results were compared between the male and female groups of neonates. Placental lesions were classified into maternal and fetal vascular malperfusion (MVM and FVM) lesions, maternal and fetal inflammatory responses (MIR and FIR), and villitis of unknown etiology (VUE).

Results

The male SGA group (n = 380) and the female SGA group (n = 363) did not differ in regard to maternal age, BMI, smoking, associated pregnancy complications, gestational age, and mode of delivery. Neonates in the SGA male group had increased birth-weight and increased respiratory morbidity as compared to the female SGA group (p = 0.007, p = 0.005, respectively). There was no between-group differences in the rate of placental lesions. By multivariate logistic regression analysis, male gender (aOR 1.55, 95% CI 1.05–2.30, p = 0.025), FIR (aOR 4.83, 95% CI 1.07–13.66, p = 0.003), and VUE (aOR 1.89, 95% CI 1.03–3.47, p = 0.04), were found to be independently associated with adverse composite neonatal outcome.

Discussion

Male gender as well as placental FIR and VUE are independently associated with adverse neonatal outcome in SGA neonates.

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Author notes

  1. Liliya Tamayev and Letizia Schreiber have contributed equally to this work.

Authors and Affiliations

  1. Departments of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 5, 58100, Holon, Israel

    Liliya Tamayev, Adi Marciano, Jacob Bar & Michal Kovo

  2. Departments of Pathology, Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel

    Letizia Schreiber

Authors
  1. Liliya Tamayev
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  2. Letizia Schreiber
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  3. Adi Marciano
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  4. Jacob Bar
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  5. Michal Kovo
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Correspondence to Liliya Tamayev.

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Tamayev, L., Schreiber, L., Marciano, A. et al. Are there gender-specific differences in pregnancy outcome and placental abnormalities of pregnancies complicated with small for gestational age?. Arch Gynecol Obstet 301, 1147–1151 (2020). https://doi.org/10.1007/s00404-020-05514-5

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  • DOI: https://doi.org/10.1007/s00404-020-05514-5

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